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Nonischemic Left Ventricular Scar as a Substrate of LifeThreatening Ventricular Arrhythmias and Sudden Cardiac
Death in Competitive Athletes
by Alessandro Zorzi, Martina Perazzolo Marra, Ilaria Rigato, Manuel De Lazzari,
Angela Susana, Alice Niero, Kalliopi Pilichou, Federico Migliore, Stefania Rizzo,
Benedetta Giorgi, Giorgio De Conti, Patrizio Sarto, Luis Serratosa, Giampiero Patrizi,
Elia De Maria, Antonio Pelliccia, Cristina Basso, Maurizio Schiavon, Barbara Bauce,
Sabino Iliceto, Gaetano Thiene, and Domenico Corrado
Circ Arrhythm Electrophysiol
Volume 9(7):e004229
July 7, 2016
Copyright © American Heart Association, Inc. All rights reserved.
A 42-y-old martial art player presenting with frequent and coupled premature ventricular beats
with right bundle branch block/superior axis morphology during exercise testing (A).
Alessandro Zorzi et al. Circ Arrhythm Electrophysiol.
2016;9:e004229
Copyright © American Heart Association, Inc. All rights reserved.
A 23-y-old soccer player who suffered syncope during a match.
Alessandro Zorzi et al. Circ Arrhythm Electrophysiol.
2016;9:e004229
Copyright © American Heart Association, Inc. All rights reserved.
Short-axis postcontrast cardiac magnetic resonance views of a 27-y-old rower with frequent
premature ventricular beats with a left bundle branch block/inferior axis morphology (suggestive
of right ventricular outflow tract origin) (A) and in a 31-y-old healthy marathon runner without
arrhythmias (B) showing late gadolinium enhancement with a spotty pattern at the inferior
insertion point of the right ventricular free wall to the interventricular septum (black arrows).
Alessandro Zorzi et al. Circ Arrhythm Electrophysiol.
2016;9:e004229
Copyright © American Heart Association, Inc. All rights reserved.
A 18-y-old tennis player who underwent contrast-enhancement cardiac magnetic resonance for
inferolateral T-wave inversion at baseline 12-lead ECG (A) and frequent ventricular ectopic beats
with a right bundle branch block/superior axis at exercise testing (B).
Alessandro Zorzi et al. Circ Arrhythm Electrophysiol.
2016;9:e004229
Copyright © American Heart Association, Inc. All rights reserved.
Long-axis (A and C) and short-axis (B and D) postcontrast cardiac magnetic resonance views of
two 34-y-old identical twin brothers showing a subepicardial/midmyocardial stria of late
gadolinium enhancement involving the lateral and inferolateral left ventricular wall (white
arrows).
Alessandro Zorzi et al. Circ Arrhythm Electrophysiol.
2016;9:e004229
Copyright © American Heart Association, Inc. All rights reserved.
A, Kaplan–Meier analysis for survival from major arrhythmic events (sudden death, cardiac
arrest because of ventricular fibrillation, sustained ventricular tachycardia, or appropriate
implantable cardiac defibrillator shock) in athletes with ventricular arrhythmias and late
gadolinium enhancement (LGE), in athletes with ventricular arrhythmias and no LGE, and in
controls (with or without spotty LGE).
Alessandro Zorzi et al. Circ Arrhythm Electrophysiol.
2016;9:e004229
Copyright © American Heart Association, Inc. All rights reserved.